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Inflammaging and Cardiovascular Disease View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by shahrekord university of medical scinces Phytomedicine 23 (2016) 1119–1126 Contents lists available at ScienceDirect Phytomedicine journal homepage: www.elsevier.com/locate/phymed Inflammaging and cardiovascular disease: Management by medicinal plants ∗ Erfaneh Shayganni a, Mahmoud Bahmani b, Sedigheh Asgary c, Mahmoud Rafieian-Kopaei a, a Medical Plants Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran b Food and Beverages Safety Research Center, Urmia University of Medical Sciences, Urmia, Iran c Isfahan Cardiovascular Research Center, Isfahan University of Medical Sciences, Isfahan, Iran a r t i c l e i n f o a b s t r a c t Article history: Background: In aging, a host of molecular and cellular changes occur which accelerate alteration and progres- Received 23 August 2015 sion of inflammatory diseases. These conditions in the elderly people cause appearance of a phenomenon Revised 6 November 2015 which has been denoted as “inflammaging”. Understanding the pathogenesis and finding new methods for Accepted 10 November 2015 management of inflammaging are essential. Purpose: In this paper we tried not only to explain inflammaging and its treatments with concentrating Keywords: on medical plants but to collect a sufficient collection of anti-inflammatory plants with focusing on their Aging mechanism of action. Anti-inflammatory drugs Method: In this review paper, by searching in indexing cites, desired articles were obtained since 1995 by us- Cardiovascular disease ing keywords of inflammation, inflammaging, inflammation pathophysiology, free radicals and inflammation, Inflammation aging inflammation, inflammatory disease, and plants or herbal medicine in inflammation. Inflammaging Medicinal plants Sections: In advanced age the generation of free radicals increases in cardiovascular system. Pathological in- flammation is also associated with production of excess free radicals More importantly, chronic inflammation makes aged people susceptible to age-related diseases. Some medicinal plants have been shown promising results in inhibition of inflammaging. Some other sections such as inflammation and inflammaging in cardio- vascular diseases, oxidative stress in cardiovascular complications, prevention and treatment strategies are presented. Conclusion: The results of published papers show that the symptoms of several inflammatory diseases can be inhibited or treated by active ingredients from medicinal plants. © 2015 Elsevier GmbH. All rights reserved. Introduction ( Nasri and rafieian-kopaei 2013; Rabiei et al. 2013a; Favarato et al. 2014 ). Aging is a phenomenon resulted from genetic, epigenetic The world’s population age is increasing and the aging popula- stochastic, and environmental events in different cells and tissues. tion is a risk factor for cardiovascular diseases (CVD). Aging generally In fact in aging, a host of molecular and cellular changes occur which causes some changes which, even in absence of usual risk factors, ren- accelerate these alterations and implicate in the progression of arte- der the cardiovascular system prone to some diseases ( Lakatta 20 0 0 ). rial diseases ( Rabiei et al. 2013b; Favarato et al. 2014 ). Pathological The progressive degeneration of the heart in elderly makes it inflammation is also associated with production of excess free radi- more vulnerable to stress and causes an increase in cardiovascu- cals arising predominantly from mitochondria ( Beller 2010; Rafieian- lar morbidity and mortality ( Brodsky et al. 2004 ). Cardiovascular kopaei et al. 2012 ). There are also evidences showing that in advanced diseases are also fuelled by some other risk factors such as di- age the generation of free radicals increase in cardiovascular system abetes ( Baradaran et al. 2013; Behradmanesh et al. 2013 ), hyper- ( Judge et al. 2005; Asadbeigi et al. 2014 ). More importantly, chronic tension ( Asgary et al. 2013; Ghorbani et al. 2013 ), and obesity inflammation makes aged people susceptible to age-related diseases ( Franceschi et al. 20 0 0 ). A wide variety of diseases including diabetes ( Asadbeigi et al. Abbreviations: CVD, Cardiovascular diseases; NOS, Nitric oxide synthase; eNOS, En- 2014 ) cancer ( Azadmehr et al. 2011; Nasri and rafieian-kopaei 2014 ), dothelial nitric oxide synthase; LDLox, Oxidized low density lipoprotein; NSAIDs, Non- steroidal anti-inflammatory drugs; DMARDs, Disease-modifying agents of rheumatoid infection (Bagheri 2013; Bagheri 2013), atherosclerosis (Rafieian- diseases; NF-k β, Nuclear factor- kb. Kopaei et al. 2011; Rafieian-Kopaei et al. 2014a ), cardiovascular dis- ∗ Corresponding author. Tel./fax: + 98 383 3330709. eases ( Khosravi-Boroujeni et al., 2013; Sarrafzadegan et al. 2013 ), E-mail address: rafi[email protected] (M. Rafieian-Kopaei). Alzheimer ( Rabiei et al. 2013c, 2014 ) and other degenerative diseases http://dx.doi.org/10.1016/j.phymed.2015.11.004 0944-7113/© 2015 Elsevier GmbH. All rights reserved. 1120 E. Shayganni et al. / Phytomedicine 23 (2016) 1119–1126 ( Mardani et al. 2014; Rafieian-Kopaei et al. 2014b ) are associated with metabolic syndrome are associated with coronary vasculopathy, and increased oxidative stress and inflammatory conditions and are de- with circulating serum factors which mediate the connections be- graded in aging. Moreover, the process of inflammation is involved tween these disease conditions. These circulating mediators are in initiation and development of a wide variety of chronic diseases mostly participated in systemic inflammation. Therefore, these fac- ( Paolisso et al. 1998 ). tors may show the evidence for their connections with cardiovascular In aging the normal balance between the oxidative stress and an- pathology ( Berg and Scherer 2005; Rafieian-Kopaei 2014 ). tioxidant system culminates in cardiovascular complications. These conditions in the elderly people cause appearance of a phenomenon Inflammaging and cardiovascular diseases which has been denoted as “inflammaging”. In fact, the word inflam- maging is used to show inflammatory state in the aged individuals The association between systemic inflammation and increase in ( Franceschi et al. 20 0 0 ). the risk of cardiovascular diseases has stimulated basic and clini- Chronic inflammation in aging tissues “Inflammaging” is a perva- cal investigators to research for precise nature and the differences sive feature of aging and most age-related diseases are associated in the nature of traditional inflammation and inflammaging in rela- with inflammation. In fact inflammaging is described as systemic, tion to cardiovascular diseases. In this regard, although their different low-grade chronic inflammation in aged people, in absence of infec- roles in accelerating atherogenesis remain unresolved, however, it is tion. It is a great risk factor for mortality and morbidity in the elderly known that inflammatory response in elderly is not as fast as younger people ( Zhang et al. 2010 ). individuals. Inflammation can be beneficial facilitating the adapta- A mild inflammation is predictive of, and is associated with many tion, turnover and repair of many tissues. However, this inflammatory aging phenotypes. The etiology of inflammation in aging people and response might be impaired during aging which increase the suscep- its contribution in adverse health events is unknown. The pathways tibility to pathogens ( Griendling and FitzGerald 2003 ). that make us able to control inflammation are not fully established. More importantly, in aging period, a host of molecular and cellu- Hence, understanding the pathogenesis and finding new methods lar changes including genetic, epigenetic and environmental events for management of inflammation are beneficial. This paper, there- occur which increase the progression of arterial diseases. fore, aimed to present the recently published papers regarding in- In aged people, the tissues are mostly in a chronically inflamed flammation in cardiovascular diseases, focusing on the role of oxida- state, with no sign of infection. The generation of free radicals also tive stress. and to summarize the herbal medicines which have had increases, and makes aged people susceptible to cardiovascular dis- promising results in prevention and treatment of this phenomenon. eases ( Asadbeigi et al. 2014 ). Inflammaging is associated with increased levels of IL-1, IL-6, TNF Inflammation and cardiovascular disease and CRP which are independent risk factors for mortality and mor- bidity. In aging process interference occurs with anabolic signaling, Inflammation participates to the pathophysiology of a wide va- IL-6 and tumor necrosis factor-a increase, down-regulating insulin riety of chronic diseases particularly injury and infectious diseases. and insulin-like growth factor-1, as well as erythropoietin signaling Interaction of various cells in the adaptive and innate immune sys- and protein synthesis. Inflammaging can be due to the accumulation tems with inflammatory mediators modulates the acute and chronic of damaged macromolecules and cells which increases with age due inflammation causing various diseases. This coordination in inflam- to increased production and/or inadequate elimination. Inflammag- matory mechanisms triggers remodeling of the extracellular matrix, ing might also be due to increase in harmful agents produced by mi- oxidative stress, tissue injury, angiogenesis and fibrosis in various tis- croorganisms of the human body, including gut microbiota. In aging sues. These inflammatory mechanisms
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